MEDICARE: COMMUNITY SOLUTIONS PATHWAYS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1235658352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY SOLUTIONS PATHWAYS INC.

Provider Business Mailing Address
First Line	:	5752 PRINCESS ANNE RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3225
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5752 PRINCESS ANNE RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3225
Country	:	US
Telephone Number	:	757-461-5098
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	DESIREE REYES
Credential	:
Telephone Number	:	757-461-5098

Provider Enumeration Date	:	09/11/2017
Last Update Date	:	09/11/2017

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